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l <br /> as T <br /> evereN <br /> ® APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> Type or print Cleary with Ink <br /> PRESS HARD - YOU ARE MAKING COPIES <br /> PUBLIC WORKS <br /> EVERETT.WASHINGTON PERMIT NO. <br /> APPLICANT(UNDERSIGNED)AND FIRM REPRESENTED, IF ANY: - <br /> HEREBY APPI IES FOR PERMISSION TO_._ _ <br /> AT THE FOLLOWING LOCATION_ �� r—' t, J . L <br /> DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: 9� <br /> 'J-toKS <br /> o�� W 1 d1 5E <br /> L <br /> DRIVEWAY SECTION <br /> PERMIT IS VALID FOR 60 DAYS <br /> COPY OF THIS APPLICATION TO BE POSTED _ I" LIP <br /> ON JOBSITE. <br /> CALL FOR INSPECTION 259-881 7 <br /> 24 HOURS BEFORE CONSTRUCTION The undersigned owner hereby agrees to hold and save harmless <br /> The City of Everett from any and all claims for damages, costs, <br /> expenses.or causes of action That may arse because of Installation <br /> and maintenance of the Improvement or other rlghl-of-way use <br /> hereto applied fon and further agrees to remove same upon notice <br /> DEPARTMENT APPROVALS from the City and to rapiers public property damaged thereby, <br /> SEWER COMMUNICATIONS <br /> DRAINAGE TRAFFIC <br /> I r� <br /> WATER I PLANNING �TURE OF APPLICANT <br /> STREET 0 j t p� RPSS t/// - <br /> (p/Y/rf� CITYZIP <br /> APPROVED vlq�ffj DATE <br /> I <br /> . - y TELEPHONE NUALTERNATEALTERNATE <br /> APPROVED A ONST U TEO DATE OATS�-� <br /> INITIAL INSPECTION REQUESTED FEE 1976 <br />